Topical Dutasteride From Dr. Lupanzula

Topical Dutasteride From Dr. Lupanzula

Topical Dutasteride is now available from Dr. Emorane Lupanzula and Medikemos Hair Restoration in Brussels Belgium.

For the past twenty-two years patients have enjoyed the benefits of finasteride tablets in order to halt, and in many cases, reverse their hair loss. Then in 2006 reports began to surface regarding side effect with variable severity and over time the number of cases has climbed considerably, with a vocal minority detailing long term and even permanent side effects, most of which were sexual in nature. While most patients have not experienced any real side effects to speak of, the side effects are real for a vocal minority.

This has lead to the development of topical finasteride by numerous compounding pharmacies with the singular intent of reducing or even eliminating side effects commonly associated with finasteride. The challenge has been to prevent systemic absorption of finasteride which has proven to be partially successful. However, with the short half life, low lipophilicity and relatively low molecular weight, some systemic absorption appears to be unavoidable for some patients which can lead to a side effects, albeit at a far reduced rate. Some feel that the short half life, and necessarily high application frequency can lead to a saturation effect that makes systemic absorption next to impossible to prevent completely.

Topical Dutasteride

Dutasteride is similar to finasteride in that it prevents the conversion of testosterone into dihydrotestosterone which is thought to be the primary cause of male pattern hair loss. However, whereas finasteride blocks 5 alpha-reductase type II enzyme from converting testosterone into DHT, dutasteride blocks both 5 alpha-reductase type II and type I enzymes, which means a more comprehensive lowering of serum DHT levels in patients. Currently dutasteride has not received any government clearance to be used for hair loss treatments but in many countries it is considered acceptable to prescribe dutasteride in an “off label” capacity for patients with male pattern hair loss.

The attraction to dutasteride stems from it’s efficacy in reducing DHT levels potentially up to 50% more than the reduction seen with finasteride. In addition, the half life of dutasteride is considerably longer than finasteride which is why many prescribing doctors recommend a lower intake frequency compared to finasteride. The problem however has been similar to finasteride with regards to side effects. Although they do not appear to be as common, they still exist, which is why topical dutasteride may be the answer.

The idea behind topical dutasteride has to do with the chemical properties compared to finasteride. At the molecular level, dutasteride is more difficult to deliver as a topical agent to be absorbed through the skin due to the size of dutasteride molecules. They are larger than those of finasteride. This difficulty however becomes an advantage as the difficulty to get past the subcutaneous layer may prevent systemic absorption. The molecular size prevents deep penetration. In addition, dutasteride has a high lipophilicity of 4.94, compared to 3.03 of finasteride, which means it is less water soluble than finasteride or more “greasy”. This higher lipophilicity can in theory help dutasteride to remain in the skin longer as these properties tend to preclude the paracellular and follicular routes of ingress into the skin.

It is for these reasons that we have begun to offer topical dutasteride to our patients. We feel that the efficacy of topical dutasteride may be quite improved over that of topical finasteride and with a strong potential for having fewer side effects. Topical dutasteride is now available from Medikemos Hair Restoration in Brussels, Belgium, for all of our patients, past and future.

We offer topical dutasteride in the following formulations:

1.Dutasteride 1% Liposomal Gel – This basic formulation comes in a pump format and is recommended to take in 1ml dosage daily. Due to the makeup of our topical solution the shelf life is such that one month supply is the maximum possible in any single bottle. Therefore each bottle is valid for 30 one day uses.

2. Dutasteride 1% + Minoxidil 5% Liposomal Gel – This is the same basic formulation as our standard formulation but with the added power of minoxidil 5%. It has been often thought that combining DHT inhibitors with minoxidil creates the most favourable conditions for hair survival and regrowth and thickening of thinning native hairs.

3. Dutasteride 0,5% Liposomal Gel – A reduced dosage of Dutasteride for those that wish to start with a more conservative usage. Dutasteride is a powerful DHT inhibitor and some patients are weary of the possible side effects due to this fact. Therefore, we offer a reduced dosage alternative for those that wish to “test” the efficacy before moving on to the standard dosage.

4. Dutasteride 0,5% + Minoxidil 5% Liposomal Gel – Same as our reduced dutasteride formulation with the added power of 5% minoxidil to aid in delivery and overall effectiveness for those that wish to have the benefit of minoxidil along with the reduced dutasteride intake.

Note that the dutasteride/minoxidil combinations can replace normal minoxidil routines which ultimately saves the user from having to purchase a separate supply of minoxidil. This means a significant overall cost savings!